Hypothalamic abnormalities in schizophrenia have been associated with endocrine dysfunctions and stress response. The hypothalamus is involved in several pathways found disrupted in schizophrenia (e.g. hypothalamic–pituitary–adrenal axis, HPA axis); however the available results on potential structural hypothalamic alterations are still controversial. The aim of the study was to investigate the volumes of hypothalamus and mammillary bodies in patients with schizophrenia and healthy controls. Twenty-six patients with schizophrenia and 26 healthy controls underwent a 3T MRI scan. Hypothalamus and mammillary bodies were manually traced by a rater who was blind to subjects’ identity. General linear model was used to compare groups on hypothalamus and mammillary bodies volumes. The hypothalamus and mammillary body volumes were significantly larger in patients with schizophrenia than controls, with significant enlargement of the left hypothalamus and trends for significantly increased right hypothalamus and right mammillary body. The size of mammillary bodies is inversely correlated with negative symptoms and directly correlated with anxiety. This study showed abnormally increased sizes of hypothalamus and mammillary bodies in schizophrenia. Mammillary bodies volumes were associated to negative symptoms and anxiety. Future longitudinal studies on hypothalamus and mammillary bodies volumes and the levels of related hormones will clarify their role in modulating HPA axis in schizophrenia.

Hypothalamic abnormalities in schizophrenia have been associated with endocrine dysfunctions and stress response. The hypothalamus is involved in several pathways found disrupted in schizophrenia (e.g. hypothalamic–pituitary–adrenal axis, HPA axis); however the available results on potential structural hypothalamic alterations are still controversial. The aim of the study was to investigate the volumes of hypothalamus and mammillary bodies in patients with schizophrenia and healthy controls. Twenty-six patients with schizophrenia and 26 healthy controls underwent a 3T MRI scan. Hypothalamus and mammillary bodies were manually traced by a rater who was blind to subjects’ identity. General linear model was used to compare groups on hypothalamus and mammillary bodies volumes. The hypothalamus and mammillary body volumes were significantly larger in patients with schizophrenia than controls, with significant enlargement of the left hypothalamus and trends for significantly increased right hypothalamus and right mammillary body. The size of mammillary bodies is inversely correlated with negative symptoms and directly correlated with anxiety. This study showed abnormally increased sizes of hypothalamus and mammillary bodies in schizophrenia. Mammillary bodies volumes were associated to negative symptoms and anxiety. Future longitudinal studies on hypothalamus and mammillary bodies volumes and the levels of related hormones will clarify their role in modulating HPA axis in schizophrenia.